• Sofie A M Dhaese, Alexander D J Thooft, Andras Farkas, Jeffrey Lipman, Alain G Verstraete, Veronique Stove, Jason A Roberts, and Jan J De Waele.
• Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium. Electronic address: sofie.dhaese@ugent.be.
• J Crit Care. 2019 Aug 1; 52: 75-79.

PurposeTo evaluate target attainment of empirically dosed continuous infusion piperacillin/tazobactam (TZP) and meropenem (MER) in critically ill patients.Patients And MethodsPatients were sampled on a daily basis. TZP or MER concentrations were evaluated during the first two days antibiotic therapy. The lower limit of the target range was defined as unbound concentrations equaling 4 times the epidemiological cutoff value of P. aeruginosa. The upper limit of the target range was based on the risk of toxicity, i.e. unbound concentrations >160 mg/L for TZP and > 45 mg/L for MER. Multivariable logistic regression was used to evaluate factors associated with target attainment.ResultsData from 253 patients were analyzed. Overall, 76/205 (37.1%) and 36/48 (75%) of the patients receiving TZP or MER respectively, attained target concentrations. In multivariable analysis, estimated creatinine clearance was identified as a risk factor for target non-attainment (OR 0.988, 95%CI [0.982;0.994]). Patients receiving MER were more likely to attain target concentrations compared with patients receiving TZP (OR 6.02, 95%CI [2.12;18.4]).ConclusionTarget attainment of empiric antibiotic therapy in critically ill patients was low (37%) for TZP and moderate (75%) for MER, despite the use of a loading dose and despite optimization of the mode of infusion.Copyright © 2019 Elsevier Inc. All rights reserved.

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